Devices and methods for attaching an endolumenal gastrointestinal implant

• US 8,070,743 B2
• Filed: 05/05/2005
• Issued: 12/06/2011
• Est. Priority Date: 11/01/2002
• Status: Active Grant

• Current Assignee: ValenTx, Inc.
• Original Assignee: ValenTx, Inc.
• Inventors: Kagan, Jonathan, Dann, Mitchell, Guterman, Lee, Butters, Joshua, Swain, Paul, Fallin, T. Wade, Baldwin, Thomas
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): GRAY, PHILLIP A
• Application Number:
  US11/124,634
• Publication Number:
  US 20060020247A1
• Time in Patent Office: 2,406 Days
• Field of Search: 604/264, 604275-279, 604/96.01, 604/164.01, 604/523, 604500-522, 623/23.65, 623/23.6, 606/153
• US Class Current: 604/516
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00827 Treatment of gastro-esophageal reflux
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0472 Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 : Coils or spirals
• CPC Class Codes: A61F 2/04 : Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts A61F2/18, A61F2/20 take precedence; devices, other than stent-grafts, providing patency to, or preventing collapsing of, tubular structures of the body other than stent-grafts, e.g. stents A61F2/82; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95
• CPC Class Codes: A61F 2002/044 : Oesophagi or esophagi or gullets
• CPC Class Codes: A61F 5/0036 : Intragastrical devices
• CPC Class Codes: A61F 5/0076 : preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0086 : using clamps, folding means or the like

Abstract

The present invention provides devices and methods for attachment of an endoluminal gastrointestinal device, such as an artificial stoma device, a gastrointestinal bypass sleeve device or an attachment cuff, within a patient'"'"'s digestive tract for treatment of obesity.

Claims

1. A method of adjusting therapy in a patient, comprising the steps of:

identifying a patient with an implanted first gastrointestinal bypass tube having a first length, the first bypass tube releasably connected to a support which is attached to tissue in the vicinity of the gastroesophageal junction;

separating the first bypass tube from the support and removing the first bypass tube from the patient after separating the first bypass tube from the support;

providing a second bypass tube, having a second length which is different than the first length; and

attaching the second bypass tube to the support.

2. A method of adjusting therapy in a patient as in claim 1, wherein the second length is longer than the first length.

3. A method of adjusting therapy in a patient as in claim 1, wherein the second length is shorter than the first length.

4. A method of adjusting therapy in a patient as in claim 1, wherein the attaching step is accomplished endoscopically.

5. A method of adjusting therapy in a patient as in claim 1, wherein attaching the second bypass tube to the support comprises attaching the proximal end of the second bypass tube to the distal end of the support.

6. A method of adjusting therapy in a patient as in claim 1, wherein the support comprises an attachment cuff having a lumen therethrough for the passage of ingested contents from the cuff into the first bypass tube.

7. A method of adjusting therapy in a patient as in claim 6, wherein the attachment cuff is flexible.

8. A method of adjusting therapy in a patient as in claim 6, wherein the attachment cuff is configured to stretch by at least about 150% in the radial direction.

9. A method of adjusting therapy in a patient as in claim 1, wherein the first bypass tube has a length of at least about 50 cm.

10. A method of adjusting therapy in a patient as in claim 1, wherein the first bypass tube has a length of at least about 75 cm.

11. A method of adjusting therapy in a patient as in claim 1, wherein the first bypass tube has a length of at least about 100 cm.

12. A method of adjusting therapy in a patient as in claim 1, wherein attaching the second bypass tube to the support comprises suturing the second bypass tube to the support.

13. A method of adjusting therapy in a patient as in claim 1, wherein attaching the second bypass tube to the support comprises hooking the second bypass tube to the support.

14. A method of adjusting therapy in a patient as in claim 1, wherein attaching the second bypass tube to the support comprises stapling the second bypass tube to the support.

15. A method of adjusting therapy in a patient as in claim 1, wherein attaching the second bypass tube to the support comprises connecting a first attachment surface on the support to a second attachment surface on the second bypass tube.

16. A method of adjusting therapy in a patient as in claim 15, wherein the first attachment surface comprises an annular ridge.

17. A method of adjusting therapy in a patient as in claim 15, wherein the second attachment surface comprises a ring.